Intentional Replantation in Combination with Fibroblast Growth Factor-2 Application and Orthodontic Tooth Extrusion for Periodontal Regeneration in the Treatment of Severe Endodontic-Periodontal Lesions.

This article focuses on a novel multidisciplinary treatment approach for severe endodontic-periodontal lesions, which involve both pulpal and periodontal tissue damage in the same tooth and typically have poor prognosis due to significant bone and periodontal ligament loss. The described method combines intentional tooth replantation with horizontal rotation and deep placement, application of fibroblast growth factor-2 (FGF2) to promote periodontal regeneration, and subsequent orthodontic tooth extrusion to encourage coronal migration of periodontal tissues. A case report of a 31-year-old patient demonstrates that this approach resulted in significant bone regeneration, clinical attachment level gain, reduced probing pocket depth, and improved tooth stability over a multi-year follow-up. The authors note that while promising, this technique is complex, technique-sensitive, and applicable only when sufficient residual bone remains apically, warranting further prospective studies to establish its clinical predictability.